Cochrane · intervention · CD001830
Pit and fissure sealants for preventing dental decay in permanent teeth
Ahovuo‐Saloranta, A, Forss, H, Walsh, T, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
11
current version
GRADE rated
3
No studies
2
Included studies
38
as reported
No studies 2 · 18.2%Ungraded 6 · 54.5%Very low 2 · 18.2%Low 0 · 0%Moderate 1 · 9.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children and adolescents from the general population, aged up to 20 years | 38 studies with 7924 randomised participants; children aged 5 to 16 years; recruited from schools or dental clinics; studies conducted in 20 countries |
| Intervention | Resin/composite-based, glass ionomer-based, or new types (ormocer-based) fissure sealants placed on occlusal surfaces of permanent premolar or molar teeth to prevent caries; applied on sound surfaces or enamel lesions; direct application or after mechanical preparation of the surface | Resin/composite-based sealants (n=15 studies); glass ionomer-based sealants (n=18, incl. resin-modified); ormocer-based sealant (n=1) |
| Comparison | No sealant, or a different type of sealant material | No sealant (n=18); different sealant material (n=24) |
| Outcomes | Incidence of caries expressed as caries or no caries on occlusal surfaces of permanent premolar or molar teeth; caries defined as caries into dentine; adverse events and safety of sealants | Incidence of caries on occlusal surfaces (n=38); retention of sealants (n=38); adverse events (n=4, none observed) |
| Study designs | Randomised controlled trials with at least 12 months follow-up; both parallel-group and split-mouth study designs; unit of randomisation could be individual, group, tooth or tooth-pair | Split-mouth and parallel-group studies (38 total) |
| Timing | At least 12 months follow-up | Follow-up periods: 12 months (n=7); 24 months (n=16); 36 months (n=9); 48-54 months (n=5); 60 months (n=3); 72-84 months (n=2); 108 months (n=1) |
Search date: 2016-08. Databases: Cochrane Oral Health's Trials Register; CENTRAL; MEDLINE Ovid; Embase Ovid; ClinicalTrials.gov; WHO ICTRP
Questions and results
Show all 5 versionsResin-based fissure sealant (2nd/3rd/4th generation) vs No sealant (control/no treatment)
Population: Children and adolescents (general population, aged under 20 years)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Caries on occlusal surfaces of permanent molars (48-54 months) 48-54 months | OR 0.21 [0.16, 0.28] | 4 studies | Ungraded |
Caries on occlusal surfaces of permanent molars (12 months) 12 months | OR 0.17 [0.10, 0.30] | 7 studies | Ungraded |
Adverse effects | Two trials measured adverse effects. None were reported. | 2 studies | Ungraded |
Caries on occlusal surfaces of permanent molars (36 months) 36 months | OR 0.17 [0.11, 0.27] | 7 studies | Ungraded |
Dentine caries in permanent molars (24 months) 24 months | OR 0.12 [0.08, 0.19] 160 per 1000 (16%); 400 per 1000 (40%); 700 per 1000 (70%) vs 52 per 1000 (31 to 74); 63 per 1000 (38 to 96); 189 per… | 7 studies · 1322 participants | Moderate Downgraded: indirectness |
Glass ionomer-based sealant vs No sealant (control/no treatment)
Population: Children and adolescents (general population, aged under 20 years)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse effects | Adverse effects not measured. | NR | No studies |
Dentine caries in permanent molars (24 months) 24 months | Inconclusive results: two studies slightly favoured glass ionomers (Liu 2014b OR 0.46 (0.23-0.91); Tagliaferro 2011) evaluating 426 children; one study (Songpaisan 1995) found no difference (MD DFS -0.18 (-0.39 to… | 3 studies · 830 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
Glass ionomer-based sealant vs Resin-based sealant
Population: Children and adolescents (general population, aged under 20 years)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse effects | One trial measured adverse effects. None reported. | 1 study | Ungraded |
Dentine caries in permanent molars 12-72 months | Inconsistent effect (differences in products, comparisons, outcomes, outcome reporting times, background fluoride and age groups); 21 trials (3883 participants randomised); very low quality | 21 studies · 3883 participants | Very low Downgraded: inconsistency, indirectness |
New types of fissure sealant (e.g. ormocer-based) vs No sealant (control)
Population: Children and adolescents (general population, aged under 20 years)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | No studies comparing new types of fissure sealants with no sealant were included. | NR | No studies |
Ormocer-based sealant vs Low-viscosity glass ionomer sealant
Population: Children and adolescents (general population, aged under 20 years)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dentine caries in permanent molars 24 months | Guler 2013 (N=50) compared ormocer-based sealant versus low-viscosity glass ionomer; not separately meta-analysed | 1 study · 50 participants | Ungraded |